Table 4.
Changes in the Quality of Care in Pilot Practices Relative to Comparison Practices
| Two Years Post-Intervention | Three Years Post-Intervention | |||||||
|---|---|---|---|---|---|---|---|---|
| General Population | Odds Ratio | Absolute Change from Baseline (95 % CI) | Effect as a % of Pilot Baseline Relative to Comparison Group | p value | Odds Ratio | Absolute Change from Baseline (95 % CI) | Effect as a % of Pilot Baseline Relative to Comparison Group | p value |
| HbA1c testing for patients with diabetes | 0.94 | −0.4 % (−0.8 %, 0.05 %) | −0.4 % | 0.09 | 0.92 | −0.6 % (−1.1 %, −0.05 %) | −0.7 % | 0.03* |
| Lipid testing for patients with diabetes | 1.01 | 0.4 % (−0.7 %, 1.6 %) | 0.5 % | 0.44 | 1 | −0.02 % (−1 %, 1 %) | 0.0 % | 0.97 |
| Dilated eye exams for patients with diabetes | 0.99 | 0.4 % (−0.5 %, 1.3 %) | 2.2 % | 0.41 | 1 | 0.2 % (−0.7 %, 1 %) | 0.9 % | 0.71 |
| Colon cancer screening | 0.85 | −4.7 % (−6.5 %, −2.9 %) | −21.1 % | <.001* | 0.88 | −4.0 % (−5.7 %, −2.4 %) | −18.1 % | < 0.001* |
| Breast cancer screening | 1.02 | 1.03 % (−0.5 %, 2.5 %) | 2.1 % | 0.17 | 1.01 | 0.6 % (−0.7 %, 1.9 %) | 1.3 % | 0.35 |
| Cervical cancer screening | 1.10 | 4.7 % (3.5 %, 5.8 %) | 12.5 % | <.001* | 1.09 | 3.3 % (2.2 %, 4.5 %) | 9.0 % | < 0.001* |
| Patients with 2 or more comorbidities | Odds Ratio | Absolute Change from Baseline (95 % CI) | Effect as a % of Pilot Baseline Relative to Comparison Group | p value | Odds Ratio | % Change from Baseline (95 % CI) | Effect as a % of Pilot Baseline Relative to Comparison Group | p value |
| HbA1c testing for patients with diabetes | 1.00 | −0.2 % (−1.0 %, 0.6 %) | −0.2 % | 0.64 | 0.96 | −0.4 % (−1.2 %, 0.5 %) | −0.4 % | 0.39 |
| Lipid testing for patients with diabetes | 1.00 | 0.11 % (−2.0 %, 2.2 %) | 0.1 % | 0.91 | 0.98 | −0.7 % (−2.4 %, 1.1 %) | −0.8 % | 0.45 |
| Dilated eye exams for patients with diabetes | 1.02 | 0.1 % (−0.7 %, 1.0 %) | 0.5 % | 0.81 | 1.04 | 0.2 % (−0.6 %, 0.9 %) | 0.9 % | 0.65 |
| Colon cancer screening | 0.88 | −4.1 % (−7.0 %, −1.2 %) | −23.0 % | .005* | 0.88 | −3.6 (−6.7 %, −0.6 %) | −20.3 % | .02* |
| Breast cancer screening | 1.06 | 3.5 % (0.9 %, 6.2 %) | 6.8 % | 0.01* | 1.05 | 2.6 % (0.3 %, 4.9 %) | 5.1 % | .03* |
| Cervical cancer screening | 1.12 | 6.2 % (3.3 %, 9.0 %) | 16.2 % | <.001* | 1.09 | 4.4 % (1.8 %, 7.0 %) | 11.5 % | .001* |
Notes: HbA1c is hemoglobin A1c. Quality measures are measured per patient on an annual basis. Only patients with diabetes were included in the measures of HbA1c, lipid testing and eye exams. The denominator for colon cancer screening is limited to patients over 50 years of age. The denominator for breast cancer screening is limited to women over 40 years of age. The denominator for cervical cancer screening is limited to women between the ages of 21 and 64 years of age. For details of colon, breast and cervical cancer screening measures, please see Methods section. Odds ratios measure the increase post-intervention in the odds that a pilot practice patient as compared to a comparison practice patient received the recommended test. Odds ratios greater than one indicate improved quality. *denotes statistically significant at the 0.05 level